The aging of the baby boomers—the generation born between 1945-1964—has led to an unprecedented expansion in the nation’s elderly population. For the past six years—and for the next fourteen years—10,000 Americans will turn 65 each day. Improvements in public health, preventative care and precision medicine have collectively led to extended lifespans. Those extensions are of varying quality: as part of longer lives, Americans have acquired chronic illnesses, infirmities and frailties.

The quest for life extension and quality is seemingly opposed by the inevitability of death and by economic limits on treatment. For example, more than ¼ of the Medicare budget is routinely expended in the last year of life. Such expenditures are often seen as appropriate: there is a prevailing belief that given sufficient investment in science and technology, longer and better lives will become available to the majority of Americans. Yet death is inevitable: the next several decades will witness unprecedented mortality in the USA and in much of the developed world.

Complex systems science is a discipline and a method that aims to understand rich behaviors arising from physical, biological and social systems with few agents and simple rules governing behaviors of those agents. The successes of complex systems analysis are familiar, even if the science is not: improvements in modern weather forecasting, in the preservation of food webs and in the selection of strains for the flu vaccine have all emerged from complex systems science.

In this one-day conference, 6 speakers and the meeting's diverse participants will interact to describe and shape opportunities for the application of complex systems science to challenges around end-of-life decision-making and care. The three themes for this conference are: biology, beliefs, and behaviors.

For biology, speakers and the audience will explore the notions of aging of complex systems. Are biological systems different from engineered systems? How do we know that complex systems are in a dying process? How do we know when medical interventions are merely prolonging death instead of creating opportunity for extended meaningful life? What do other biological systems tell us about hard limits on longevity?

For beliefs, speakers and the audience will explore the prevailing belief systems around death and dying, including definitions of death; beliefs pertaining to the promise of medical, biological and engineering sciences to mitigate pain, illness, frailty; faith-related constructs and cultural attitudes regarding clinical obligations and the purpose of medical care near end-of-life; and the influence of popular culture on individual decision-making. Beliefs around the emergence of chronic illness –and the influences of medicine, environment and policy—will be addressed

For behaviors, speakers and the audience will explore the intersection of medical economics and social norms towards a discussion of decision-making influenced by individual, family, community, healthcare system, industrial, regulatory and governmental perspectives. Domestic and international case-studies will be used to illuminate intended and unintended consequences of policy decisions.

ACtioN Meetings are open to members of the Applied Complexity Network and invited special guests. Please contact action@santafe.edu if you would like more information on becoming a member.

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